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Techniques in Coloproctology

, Volume 22, Issue 3, pp 215–221 | Cite as

The effect of metabolic syndrome on postoperative outcomes following laparoscopic colectomy

  • A. Zarzavadjian Le Bian
  • C. Denet
  • N. Tabchouri
  • H. Levard
  • R. Besson
  • T. Perniceni
  • R. Costi
  • P. Wind
  • D. Fuks
  • B. Gayet
Original Article

Abstract

Background

Among the criteria used to diagnose metabolic syndrome (MS), obesity and diabetes mellitus (DM) are associated with poor postoperative outcomes following colectomy. MS is also associated with colorectal cancer (CRC) and diverticulosis, both of which may be treated with colectomy. However, the effect of MS on postoperative outcomes following laparoscopic colectomy has yet to be clarified.

Methods

In an academic tertiary hospital, data from all consecutive patients undergoing laparoscopic colectomy from 2005 to 2014 were prospectively recorded and analysed. Patients presenting with MS [defined by the presence of three or more of the following criteria: elevated blood pressure, body mass index > 28 kg/m2, dyslipidemia (decreased serum HDL cholesterol, increased serum triglycerides) and increased fasting glucose/DM] were compared with patients without MS regarding peri-operative outcome [mainly anastomotic leaks, severe postoperative complications (Clavien–Dindo III and IV)] and mortality.

Results

Overall, 1236 patients were included: 508 (41.1%) right colectomies and 728 (58.9%) left colectomies. Seven hundred seventy-two (62.4%) of these procedures were performed for CRC. MS was diagnosed in 85 (6.9%) patients, who were significantly older than the others (70 vs. 64.2 years, p < 0.001), and presented with more cardiac comorbidities (p < 0.001). MS was associated with increased blood loss (122.5 vs. 79.9 mL p = 0.001) and blood transfusion requirement (5.9 vs. 1.7%, p = 0.021). The anastomotic leak rate was 6.6% (with 2.2% of anastomotic leaks requiring surgical treatment), and the overall reoperation rate was 6.9%. The incidence of severe postoperative complications was 11.5%, and the overall mortality rate 0.6%. No differences were found between the groups in overall postoperative morbidity and mortality. Median length of stay was similar in both groups (7 days).

Conclusions

MS does not jeopardize postoperative outcomes following laparoscopic colectomy.

Keywords

Metabolic syndrome Laparoscopic colectomy Postoperative outcomes Obesity Diabetes mellitus 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Digestive Surgery, Avicenne HospitalParis XIII UniversityBobignyFrance
  2. 2.Laboratory of Medical Ethics and Legal MedicineDescartes University ParisParisFrance
  3. 3.Department of Digestive DiseasesMutualiste Montsouris Institute ParisParisFrance
  4. 4.Department of SurgeryUniversity of ParmaParmaItaly
  5. 5.Faculty of MedicineDescartes UniversityParisFrance

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